Effects of Esketamine on Postoperative Hospital Anxiety and Depression Scale Scores

This was a prospective, randomized, placebo-controlled clinical trial. Adult patients scheduled for elective laparoscopic radical resection at Xiangya Hospital were enrolled. Participants were randomly assigned in a 1:1 ratio to a control group (group C) or an esketamine group (group PE). Group C received conventional general anesthesia and patient-controlled intravenous analgesia (PCIA). In group PE, esketamine 0.5 mg/kg was administered intravenously during induction of anesthesia, and esketamine 1 mg/kg was added to the PCIA regimen. The primary outcome was the HADS score on postoperative day 1. Secondary outcomes included HADS scores on postoperative days 3 and 7, sleep quality scores, postoperative level of consciousness, incidence of acute postoperative complications, length of hospital stay, postoperative inflammatory marker levels, and satisfaction scores.
Compared with group C, group PE showed significantly lower HADS-A and HADS-D scores on postoperative days 1 and 3 (P < 0.05). Postoperative interleukin-6 (IL-6) levels were significantly lower in group PE than in the group C (P < 0.05). Patient satisfaction was significantly higher in group PE than in group C (P < 0.05).
Conclusions: The use of esketamine during induction of general anesthesia and in postoperative PCIA reduced HADS scores on postoperative days 1 and 3 and improved patient satisfaction in patients undergoing colorectal cancer surgery.
Note: HADS-A, anxiety subscale of the Hospital Anxiety and Depression Scale; HADS-D, depression subscale of the Hospital Anxiety and Depression Scale. Data are presented as median (P25, P75). Group C, placebo group; group PE, esketamine group. D1, postoperative day 1; D3, postoperative day 3; D7, postoperative day 7.